Lactic acidosis caused by thiamine deficiency in a pregnant alcoholic patient

Metabolic acidosis from accumulation of lactic acid is a relatively common condition, whereas its causation by thiamine deficiency is not.

We studied a pregnant alcoholic patient who presented with hyperemesis and a high anion gap acidosis.

Lactic acidosis and thiamine deficiency were confirmed. The patient's symptoms and acidosis resolved with thiamine administration.

Lactic acidosis caused by thiamine deficiency must be suspected when pregnant patients at risk for thiamine deficiency present with a high anion gap acidosis. A large dose of thiamine must be administered immediately.